NPI 1245598390

Magnolia Na, LLC

Organisation Assisted Living Facility Tupelo, MS

Practice location

Address: 117 N Broadway St, Tupelo, MS 38804-3901
Phone: (662) 840-3111
Fax: (662) 840-3119
Mailing address: 1515 Munsford Dr, New Albany, MS 38652-7407

Authorised official

Name: Art Shannon
Title: Chief Operating Officer
Phone: (662) 891-3054

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence 848 (MS)

Other Assisted Living Facility providers in Mississippi →

Registry record

NPI: 1245598390
Entity type: Organization
NPI issued: 26 Apr 2012
Record last updated: 26 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.